My Latest Challenge

Never a dull moment in life as we age... mine has been a roller-coaster of late... to say the least. About ten years ago I was lucky to have been able to have a diagnosis of a genetic heart defect; one that was getting to the stage that it could suddenly end my life. It was a bicuspid aortic valve... and it had a calcific stenosis that had become acute. Through persistence and the help of close colleagues in the cardiology business, I was able to have a heart catheterization when I thought I had symptoms of some sort of heart problem. This led to the diagnosis of a heart valve in crisis, even though the heart itself was otherwise in great condition.

My 2001 open heart surgery that followed was a sudden experience... one that I haven't shared on this blog. This, because it has always seemed that my subsequent and unrelated cancer was something I could share to the benefit of others, by exposing the issues associated with the epidemic of cancer. In comparison, cancer takes many more lives than my heart valve problem, so I have in the past highlighted the cancer issues.

However, by annually having an echo-cardiogram, we followed the performance of the prosthetic valve that was placed at the Arkansas Heart Hospital by a fabulous team of professionals. In July this year, I became aware that again, my aortic valve was developing problems. It wasn't enough to stop me from my cycling projects, but it did cause me to be much more aware of my sagging performance over the fall months. In an echo cardiogram follow-up this month, we found that the valve is approaching acute failure at an alarming rate of speed. It is again calcified, and has to be replaced.

I want to help people understand this little understood heart ailment. I will copy below the layman details of Aortic Valve Stenosis. This is from Wiki, but is quite accurate, so worth reading. It is a silent killer most of the time, although people who 'listen' to their bodies... and are aware of their exercise output capacities can in some instances catch things like I suffer from, before being killed by them. By my continuous effort to stay in shape, listening to my body, I have been lucky enough to twice now, catch this thing. Yes, I am lucky to have made a career choice that kept me in the medical device arena, therefore close to people who can help, but first, I have had to be in shape and listening, in order to question the things I occasionally feel, about my output.

So, what does this mean. Well, "its elementary", to quote Sherlock Holmes in "The Crooked Man"... replacement can happen in two ways... First, open heart surgery is the way I was treated ten years ago, and that remains the Gold Standard today. There is a new technique, still under clinical investigation/trial here in North America. It is called TAVI, but it is yet unproven to the standards here, and it is not at all approved for "re-do" situations, like mine.

After a good deal of consultation I have decided to have the Gold Standard procedure, open heart surgery... even though the recovery period is much longer. I had seriously considered the TAVI be done 'off-label', but there was in the end no reward for the risks involved in a procedure that does not have clinical efficacy, here in North America. I have a great level of respect for the clinical trial process that is utilized to 'prove' a new technique or device... and in our decision, Lynnda and I leaned on the experience we have had at the Arkansas Heart Hospital and our friends there, who have over the years been our great care-givers to both of us.

I will keep my blog updated as to the procedure, the outcome and so on. I am very confident in my physicians and in the outcome.

For the moment, my message is, again, that it is very important to understand that when one gets sick (and with time we all will), it is important to be in the best physical condition possible. Why? Simply because it opens doors to treatments that could otherwise be closed. When we battle cancer, or trauma, or congenital diseases, our chances of success are enhanced if you are starting out with good vascular and pulmonary function. These good conditions accumulate through cardiovascular and stretching exercise; healthy eating and weight management; great dental hygiene; non-smoking; avoiding environmental hazards; and so on.

Further, it is important to have regular check-ups and listen to your body when it is telling you things... don't hang up on your 'wake-up calls'.

Here is a pretty good description of my problems...just copy this and paste into your browser...

Below is a cool video of the procedure that I will have in January... since I have had it before, I know what to look forward to... great drugs, beer on the second evening, and lots of moderate exercise for six weeks or so... then, back in the saddle!


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